Carotid intima-media thickness and carotid plaques in cardiovascular risk assessment

Current cardiovascular (CV) risk assessment tools using clinical risk factors alone are inadequate for predicting CV disease in low- to intermediate-risk patients. The presence of elevated carotid intimamedia thickness (CIMT) is a well-established risk factor for the development of CV disease. Recent studies have shown that the presence of carotid plaques is also a strong predictor of disease, independent of CIMT. Furthermore, complex carotid plaques are associated with both the acute coronary syndrome and cerebrovascular events. The use of subclinical atherosclerosis, defined as elevated CIMT or the presence of carotid plaques, in addition to clinical risk factor assessment is a sensitive method to assess future CV risk.